Severe Hemorrhage Requiring Transfusion in Two Dogs Following Right Inferior Alveolar Artery Laceration Secondary to Severe Periodontitis.

IAA erosion from severe periodontitis can cause life-threatening hemorrhage requiring emergency surgical ligation in dogs.

This case series describes two dogs presenting with severe oral hemorrhage secondary to inferior alveolar artery (IAA) laceration caused by advanced periodontitis — the first published report of this condition in any species. A 9-year-old Jack Russell Terrier and a 12-year-old Bearded Collie were referred for stomatorrhagia, melena, and hematemesis, both presenting with significant anemia (PCV 20–21%). The Jack Russell Terrier also exhibited signs of hemorrhagic shock and hyperfibrinolysis on viscoelastic testing, while standard coagulation parameters (PT, aPTT, platelet count) were normal in both cases. Hemorrhage originated from the right mandibular first molar region in both dogs. Initial stabilization included IV fluid resuscitation, tranexamic acid, and packed RBC transfusions. Definitive diagnosis was confirmed via intraoperative dental radiographs (Case 1) and preoperative CT imaging (Case 2). Surgical management required anesthesia, dental extraction, and ligation of the right IAA, which was curative for oral hemorrhage in both cases. Case 1 subsequently died due to unrelated comorbidities. This report highlights IAA erosion secondary to periodontitis as an underrecognized but life-threatening cause of oral hemorrhage in dogs. Clinicians should include IAA laceration in the differential diagnosis for severe stomatorrhagia and be prepared for emergency surgical intervention, including arterial ligation, in affected patients.

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